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Introducing Brokers :

Introducing Broker ("IB") Questionnaire

First Name

Last Name

Company Name, if any

Street Address

City

Postal Code

Country

Telephone Number (Home)

Telephone Number (Office)

e-mail Address

Are you interested in Introducing Broker opportunities for yourself or for your Company?

How would you describe your current position as an Introducing Broker or Market participant?

	Beginner - Starting to explore opportunities and gather Information

	Intermediate - Have begun to build business / obtain clients

	Advanced - I have an existing business with clients currently trading

If "Advanced" what is your estimate of your clients' current monthly trading volume?

USD :

/month

What is the website address of your business, if any?

http://

What other information can you provide us about your existing business and goals with ONYX?

Any other questions or comments?

Where did you hear about ONYX?